Portable wide-field digital imaging for screening of neonatal visual impairment causes in Rio de Janeiro, Brazil: a budget impact analysis

• Published in: BMJ open Vol. 12; no. 6; p. e056498
• Main Authors: Haefeli, Lorena M, Neves, Luiza M, Zin, Andrea, Costa, Ana Carolina Carioca, Farias Meira de Vasconcelos, Zilton, Pinto, Marcia
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 10.06.2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Blindness; Brazil; Budgets; Costs and Cost Analysis; Digital technology; Female; Government; Health Economics; Humans; Impact analysis; Infant, Newborn; Medical diagnosis; Medical screening; Neonatal screening; Newborn babies; Pregnancy; Premature babies; Telemedicine; Vision Disorders; Visual impairment; Brazil; Rio de Janeiro Brazil; Telemedicine; Costs and cost Analysis; Neonatal screening; Vision Disorders
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-056498

ObjectiveTo estimate the budget impact of portable wide-field digital imaging incorporation on screening neonatal causes of childhood blindness and visual impairment in Rio de Janeiro, Brazil.DesignBudget impact analysis.SettingRio de Janeiro, Brazil.Primary and secondary outcome measuresThe primary outcome was the direct cost of indirect binocular ophthalmoscopy, red reflex test and portable wide-field digital image screening comprising all babies born in Rio de Janeiro’s government maternity wards. The secondary outcome was the budget impact of implementing portable wide-field digital image screening in Rio de Janeiro, Brazil.ResultsConsidering 100% coverage of maternity wards, the total budget impact between 2020 and 2024 would be US$3 820 706.04, ranging from US$3 139 844.34 to US$6 099 510.35. The additional cost would be US$3 124 457.28, ranging from US$2 714 492.26 to US$4 880 608.63.ConclusionThe cost of universal digital imaging screening corresponds to less than 1% of the government health budget of the city of Rio de Janeiro. The information provided in this study may help government decision-makers evaluate the feasibility of implementing this new strategy in the municipal setting. Further health economic evaluations should be performed to verify the affordability of the implementation of this screening strategy in the Brazilian scenario, taking into account scarce human resources.